A Case For Prostate Cancer Screening
- The screening process for prostate cancer enables doctors to offer improved treatment options and a greater chance of a cure for patients.
- Screening consists of a test to measure prostate-specific antigen (PSA) in the blood and may also include a digital rectal exam (DRE) that allows the doctor to check your prostate for lumps.
- The idea behind the screening process is to identify the disease at an early-stage so that it is easier to treat — or it can be monitored if treatment is not recommended right away.
- Screening recommendations are based on risk, but the American Cancer Society suggests that most men talk to their doctors about screening plans at age 50.
For prostate cancer, screening consists of a test to measure prostate-specific antigen (PSA) in the blood and may also include a digital rectal exam (DRE) that allows the doctor to check your prostate for lumps. This exam may be uncomfortable, but it is brief — it shouldn’t last for more than a minute. Based on the results of your PSA and DRE, your doctor may recommend additional testing including a biopsy or imaging such as a prostate MRI.
Read MoreProstate Cancer Screening: The Basics
As previously mentioned, the screening for prostate cancer often includes testing the prostate-specific antigen (PSA) levels in a man’s blood and/or a digital rectal exam (DRE). For a DRE, the doctor puts a gloved, lubricated finger into the rectum to feel the prostate gland and monitor for anything abnormal.The PSA is a normal protein found in men’s blood. Contrary to what many patients believe, this protein is produced by both normal and malignant (cancerous) prostatic cells. As it is not malignant-specific, some conditions can increase its blood levels without meaning you have cancer, including age, ejaculation, riding a bicycle, having an enlarged prostate, and some medicines.
Patients should know that regular testing with a PSA test, particularly for men between the ages or 55 and 69, is recommended.
“It’s a $20 test. You do a PSA, you get to know what’s going on. Now, if you find that this guy is 82 years old, he’s got a PSA of just borderline 5.2, don’t do anything. Just keep monitoring it. But at least you have a baseline,” Dr. Razdan explains, referring to how for some patients, treatment is not recommended.
The most important take-home message you need to have is that there is no set cutoff point to affirm if a patient does have or doesn’t have prostate cancer. Rather, the PSA value works as a crucial sign (not the only one) to alert your physician to proceed with further evaluation. Generally, values above 4 ng/mL require a detailed investigation and referral to a specialist.
In this situation, the specialist is a urologist, a surgeon trained to treat conditions related to the urologic tract, such as the prostate.
The American Cancer Society issued the following prostate cancer screening guidelines for men based on age:
- Men aged 50 and older with an average risk of the disease should discuss screening with their doctors
- Men aged 45 and older who have a high-risk (due to a family history or other factors) should discuss screening early with their doctors
- Men aged 40 and older who have multiple family members who were diagnosed with prostate cancer at a young age (younger than 65) should discuss screening early with their doctors
Questions To Ask Your Doctor
- Do I need to be screened for prostate cancer?
- My father had prostate cancer. Should I be screened earlier?
- I am concerned about having prostate cancer. Can I have a PSA test ordered?
- My PSA value is within the normal range. Does this mean I don’t have prostate disease?
- What are my options is my PSA level is above normal?
- How often should I have my PSA measured?
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